ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2018
Improved Assessment of Bolus Clearance in Patients With Achalasia Using High-Resolution Impedance Manometry.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 30 citations in OpenAlex.
- Definition of Clinically Meaningful Thresholds for the Brief Esophageal Dysphagia Questionnaire and Eckardt Score: A Multicenter Psychometric Study.Neurogastroenterology and motility · 2026Article
- High-Resolution Impedance Manometry (HRIM) Using Yogurt (Viscosity Matched to Barium) for Bolus Clearance After Therapy in Achalasia.Digestive diseases and sciences · 2026Article
- Dysphagia is Associated With the Combination of Defective Bolus Transit and Poorly Relaxing Lower Esophageal Sphincter in Patients With Ineffective Esophageal Motility.Journal of neurogastroenterology and motility · 2026Article
- A novel approach to studying human orogastric transit with an ingestible bionic device. An early feasibility study.Physiological measurement · 2026Article
- Comparison of Achalasia Classification Schemes to Predict Treatment Outcomes.Neurogastroenterology and motility · 2026Article
- Assessing Treatment Outcomes in Achalasia Using 4-Dimensional High-resolution Impedance Manometry.Journal of neurogastroenterology and motility · 2025Article
- Validation of the Japanese version of the Esophageal Hypervigilance and Anxiety Scale for esophageal symptoms.Journal of gastroenterology · 2025Article
- Interpretation of Impedance Data on High-resolution Impedance Manometry Studies-A Worldwide Survey.Journal of neurogastroenterology and motility · 2024Article
- Is an objective evaluation essential for determining the therapeutic effect of laparoscopic surgery among patients with esophageal achalasia?Surgical endoscopy · 2022Article
- Dysphagia: Novel and Emerging Diagnostic Modalities.Gastroenterology clinics of North America · 2021Review
- Bolus transit of upper esophageal sphincter on high-resolution impedance manometry study correlate with the laryngopharyngeal reflux symptoms.Scientific reports · 2021Article
- [Diagnosis of Dysphagia: High Resolution Manometry & EndoFLIP].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2021Review
- Distal contractile to impedance integral ratio assist the diagnosis of pediatric ineffective esophageal motility disorder.Pediatric research · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
BACKGROUND &
aimsEsophageal retention is typically evaluated by timed-barium esophagram in patients treated for achalasia. Esophageal bolus clearance can also be evaluated using high-resolution impedance manometry. We evaluated the associations of conventional and novel high-resolution impedance manometry metrics, esophagram, and patient-reported outcomes (PROs) in achalasia.
methodsWe performed a prospective study of 70 patients with achalasia (age, 20-81 y; 30 women) treated by pneumatic dilation or myotomy who underwent follow-up evaluations from April 2013 through December 2015 (median, 12 mo after treatment; range, 3-183 mo). Patients were assessed using timed-barium esophagrams, high-resolution impedance manometry, and PROs, determined from Eckardt scores (the primary outcome) and the brief esophageal dysphagia questionnaire. Barium column height was measured from esophagrams taken 5 minutes after ingestion of barium (200 mL). Impedance-manometry was analyzed for bolus transit (dichotomized) and with a customized MATLAB program (The MathWorks, Inc, Natick, MA) to calculate the esophageal impedance integral (EII) ratio.
resultsOptimal cut points to identify a good PRO (defined as Eckardt score of ≤3) were esophagram barium column height of 3 cm (identified patients with a good PRO with 63% sensitivity and 75% specificity) and an EII ratio of 0.41 (identified patients with a good PRO with 83% sensitivity and 75% specificity). Complete bolus transit identified patients with a good PRO with 28% sensitivity and 75% specificity. Of the 25 patients who met these cut points for both esophagram barium column height and EII ratio, 23 (92%) had a good PRO. Of the 17 patients who met neither cut point, 14 (82%) had a poor PRO (Eckardt score above 3).
conclusionsIn a prospective study of 70 patients with achalasia, we found EII ratio identified patients with good PROs with higher levels of sensitivity (same specificity) than timed-barium esophagram or impedance-manometry bolus transit assessments. The EII ratio should be added to achalasia outcome evaluations that involve high-resolution impedance manometry as an independent measure and to complement timed-barium esophagram.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.